DEPARTMENT OF INSURANCE

Affiliations

Name	Kentucky Southern Insurance, LLC	DOIID	800296	NAIC NPN	16853602

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Resident	Agent	Casualty	12/26/2012	3/31/2028
Active	Resident	Agent	Property	12/26/2012	3/31/2028
Active	Resident	Agent	Health	12/26/2012	3/31/2028
Active	Resident	Agent	Life	12/26/2012	3/31/2028
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	ACE Property and Casualty Insurance Company	300520	Agent - Health	2/12/2025
Active	All Savers Insurance Company	301940	Agent - Health	4/21/2023
Active	All Savers Insurance Company	301940	Agent - Life	4/21/2023
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	1/25/2013
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	6/12/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Health	1/25/2013	4/15/2025
Inactive	Anthem Life Insurance Company	301209	Agent - Life	1/25/2013	4/15/2025
Active	Banner Life Insurance Company	301696	Agent - Life	9/6/2013
Active	CHA HMO, Inc.	300662	Agent - Health	3/3/2026
Active	Cincinnati Life Insurance Company (The)	300601	Agent - Life	4/20/2022
Active	Colonial Life and Accident Insurance Company	300846	Agent - Health	1/9/2013
Active	Colonial Life and Accident Insurance Company	300846	Agent - Life	1/9/2013
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	3/3/2016	12/13/2016
Active	CompBenefits Insurance Company	301864	Agent - Health	1/5/2021
Inactive	Dearborn Life Insurance Company	300401	Agent - Health	3/8/2013	12/8/2017
Inactive	Dearborn Life Insurance Company	300401	Agent - Life	3/8/2013	12/8/2017
Inactive	Dental Care Plus Inc.	301495	Agent - Health	2/25/2013	3/31/2025
Active	Dental Concern Inc. (The)	301641	Agent - Health	5/13/2026
Active	Fidelity Security Life Insurance Company	300466	Agent - Health	1/27/2021
Active	Fidelity Security Life Insurance Company	300466	Agent - Life	1/27/2021
Inactive	Gerber Life Insurance Company	300529	Agent - Health	4/1/2021	8/18/2023
Inactive	Gerber Life Insurance Company	300529	Agent - Life	4/1/2021	8/18/2023
Active	Guardian Life Insurance Company of America	301316	Agent - Health	1/14/2013
Active	Guardian Life Insurance Company of America	301316	Agent - Life	1/14/2013
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	2/22/2016	12/13/2016
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	1/7/2013	12/12/2024
Active	Humana Insurance Company	301104	Agent - Health	10/24/2025
Inactive	Humana Insurance Company	301104	Agent - Life	1/7/2013	12/13/2022
Active	Humana Insurance Company of Kentucky	300826	Agent - Health	10/24/2025
Active	Humana Insurance Company of Kentucky	300826	Agent - Life	10/24/2025
Active	Insurance Company of North America	300226	Agent - Health	9/25/2025
Inactive	Kanawha Insurance Company	300127	Agent - Health	1/7/2013	12/8/2017
Inactive	Kanawha Insurance Company	300127	Agent - Life	1/7/2013	12/8/2017
Inactive	Kentucky Health Cooperative, Inc.	798780	Agent - Health	10/21/2013	10/29/2015
Active	Metropolitan Life Insurance Company	301948	Agent - Health	1/17/2013
Active	Metropolitan Life Insurance Company	301948	Agent - Life	1/17/2013
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	2/11/2016	12/22/2016
Inactive	Omaha Insurance Company	751908	Agent - Health	2/11/2016	12/22/2016
Active	Principal Life Insurance Company	300129	Agent - Health	11/22/2021
Active	Principal Life Insurance Company	300129	Agent - Life	11/22/2021
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	1/4/2021	11/30/2023
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	1/4/2021	11/30/2023
Inactive	Pruco Life Insurance Company	300954	Agent - Life	10/6/2015	12/23/2024
Active	Standard Insurance Company	300185	Agent - Health	1/6/2013
Active	Standard Insurance Company	300185	Agent - Life	1/6/2013
Inactive	Starmount Life Insurance Company	628031	Agent - Health	1/4/2021	11/30/2023
Active	Sun Life Assurance Company of Canada	301811	Agent - Health	3/7/2019
Active	Sun Life Assurance Company of Canada	301811	Agent - Life	3/7/2019
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	1/4/2021	11/30/2023
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	1/4/2021	11/30/2023
Inactive	Union Security Insurance Company	301844	Agent - Health	3/11/2013	12/21/2020
Inactive	Union Security Insurance Company	301844	Agent - Life	3/11/2013	12/21/2020
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	2/11/2016	12/22/2016
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	2/11/2016	12/22/2016
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	9/28/2016
Active	UnitedHealthcare Insurance Company	300946	Agent - Life	9/28/2016
Active	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	9/28/2016
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	4/14/2022	12/17/2024
Inactive	Unum Insurance Company	301499	Agent - Health	1/4/2021	11/30/2023
Inactive	Unum Insurance Company	301499	Agent - Life	1/4/2021	11/30/2023

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Meyer, David Thomas	317538	Agent - Casualty	12/26/2012
Active	Meyer, David Thomas	317538	Agent - Health	12/26/2012
Active	Meyer, David Thomas	317538	Agent - Life	12/26/2012
Active	Meyer, David Thomas	317538	Agent - Property	12/26/2012
Inactive	Winokur, Gregory H	631819	Agent - Health	12/11/2019	1/1/2024
Inactive	Winokur, Gregory H	631819	Agent - Life	12/11/2019	1/1/2024